Diagnosis of Intermittent Explosive Disorder Essay

Strengths-Focused Introduction to Consumer

Mark resides in southern Victoria, Australia, in a family of five comprising a wife and three children. He is fully employed by the government of Australia and spends most of his time managing his juniors. Mark engages in the livestock business as a part-timer, which tends to be his primary source of income. Mark’s main source of income is agriculture. He actively participates in physical exercise as part of his daily routine every morning. Physical activity revitalizes the body and keeps him fit at all times. Additionally, he is cautious about his diet and effectively adheres to meal budgeting. He participates in problem-solving and maintains emotional support programs as a coping strategy for his condition.

Mark was first admitted to the hospital through the help of the mental health community empowerment team. Following the notification from his wife regarding the change of behaviors, the group visited Mark’s home and advised his admission. Mark was found to have withdrawal syndromes, which were mainly isolating him from family and friends. Also, he had extreme mood fluctuations and sleeping problems that resulted in missing work. Mark’s aggressiveness rapidly increased; he developed uncontrolled anger and other worrying actions that the wife feared could turn catastrophic. His safety at home became a primary concern of his wife and children, that felt threatened.

Problem and Initial Assessment in Adult Acute Mental Health Service

Present Problem

Upon admission to the hospital, it was observed that Mark had signs of intermittent explosive disorder (IED). IED is characterized by a person being angry and verbally outbursts or acting aggressively out of proportion to what is provoking (Scott et al., 2020). In most cases, when such a person is not well treated, the individual may end up being a threat to others. This mental problem is often perceived to originate from either young age or adolescence but manifests itself later at individual age.

Initial Assessment

1. Based on the initial assessment, it was found that Mark had a strange appearance which was mainly associated with a facially visible agitation. He manifested strange and violent behaviors toward anyone who came in contact with home. He was physically aggressive toward other people. Mark visibly had verbal outbursts, which indicated his disappointment levels. Further, he entailed sudden episodes of impulsive behaviors.
2. Mark had an attitude that mainly showcased anger and disappointment. His mood was sad and worrying, replicated in how he handled the medical personnel.
3. His speech was observed as an angry verbal outburst. He also manifested fast speech, contributed by racing thoughts.
4. Upon assessment, he was found to have a racing thought that was replaced in his speech and actions.
5. It was observed that mark had severe cases of repeated thought content. Also, he had signs of sudden impulsive and violent thought content.
6. The assessment revealed that mark had a negative perception of life, people, and relationship.
7. Regarding memory, Mark was based on having a declining memory functionally. He also had a declining cognitive capability due to poor judgment.
8. Mark’s assessment indicated poor insight supported by his actions. Further, he had poor judgment as he filed to differentiate his actions to wither right or wrong.
9. The assessment indicated a higher degree of risk to self. For instance, Mark’s actions were considered to be self-threatening.
10. It was also found that Mark was vulnerable to accidental injury, mainly due to his poor judgment.

Diagnosis

DSM-IV: Intermittent Explosive Disorder (IED)-instances of verbal aggression, emotional control problems, violation of social norms, and impulse control disorders.

Mental Health Act

Mark was a compulsory patient who was obliged to be admitted to the basement based on the Victorian Mental Health Act (2014), Australia. The act was instrumental in protecting people having mental illnesses.

Nursing Diagnoses and Recovery Goals

Nursing Diagnoses

The intermittent explosive disorder nursing diagnosis involves the patient’s relaxation training. Secondly, training on cognitive restructuring implies the manner individual thinks.

Training on fundamental coping skills.

Additionally, the use of fluoxetine drug is adopted, and finally, the administration of phenytoin and oxcarbazepine drugs during the treatment stage.

Recovery Goals

Based on the condition, mark’s recovery goals included an enhanced understanding of anger and feelings towards anger to initiate stoppages. This involves the development of an appropriate short-term plan that will institute dealing with anger. Secondly, addressing the key aspects behind the agreement on feelings. Particularly identifying anger from experience and resolving to let go of the anger. Thirdly, the irrational perception and thinking aspects result in anger. This involves identifying vital areas of cognitive distortion and initiating an action plan to manage anger thinking. It also consists in challenging the perceived irrational through the acute reality. Further, this entails identifying issues considered self-defeating and respective aggressive bevors.

It addresses the key areas that result in a likelihood of conflict once he returns to the community. This is instrumental as it will majorly focus on minimizing incidents involving socialization. Finally, decreasing high cases of anger and violence. Anger leads to individuals messing up in many ways, and thus there is a need to work on favorable methods to control it. Reducing anger and violence majorly entails learning vital coping strategies to manage any resentment. Further, it entails progressive muscle relaxation and training on deep breathing mechanisms to manage anger.

Nursing Care Plan

Generally, a treatment nursing care plan was adopted to handle Mark’s ailment. The nursing plan ensures that the treatment process goes per the nursing act and nothing goes wrong. For instance, the program started with an effective assessment. Under the examination, the facility scrutinized Mark to ascertain the visible and manifested conditions. Secondly, the plan stipulated an effective diagnosis for Mark. This involved detailed procedures while effectively identifying the situation he was suffering. Thirdly, the program came up with goals of diagnosis, from which a series of expectations were set. Finally, the treatment administered to Mark was reiterated and executed effectively.

The outcome of the care plan was a positive recovery, followed by a change in behavioral conduct after the therapy. The result was highly reliable and instituted attainment of desirable outcomes that facilitated efficiency in the recovery—the plan entitled detailed therapy and treatments that were instrumental in the outcome generated. The appropriate interventions and rate of treatment further eased recovery goals.

Reflection

Relatively, the consumer situation during the admission was highly critical. It was fundamental and to the patient’s benefit that he was admitted on a timely basis. The degree of impact following the onset of the symptoms implied that the patient was already suffering severe impacts from the illness. A quick response from the patient’s wife was considered a fundamental aspect that saved the life and memory of the patient.

Based on the case, the key learnings include the following. Firstly, early detection and seeking help was fundamental element that significantly contributed to planning possible treatment plans and therapies (Craster & Forrester, 2020). The consequence of this learning was effective in obtaining the most appropriate treatment plan for the patient, as a critical role of the nursing organization. Secondly, early detection of patient conditions greatly facilitated providing the correct information and resources and supported the patients. This was highly helpful in nursing practice as it enabled effective care planning.

Thirdly, the early patient diagnosis was a vital lesson that enabled health nursing to effectively protect the patients by administering reliable treatment as per the condition requirement. Finally, the case expressed above was essential and instrumental in initiating corrective mechanisms for individuals with mental disabilities (Den et al., 2019). Such highly played a vital role in safeguarding the patient from uncertainties assorted with mental illness. For instance, postponement of care-seeking could otherwise have drastic impacts on the patients’ health, most of which were irreversible impacts. Therefore, both the hospital and the nursing health practice are fully tasked with creating community awareness to facilitate the guiding of the general Australian public. Notably, the community team should major in creating awareness to address underlying mental illness issues. Additionally, the focus should be on the best ways to reach the hospital if individuals experience unusual conditions. Also, the community should be encouraged and educated on mental illness and other conditions to facilitate early detection and treatment, respectively.

References

Den Boer, K., de Veer, A. J., Schoonmade, L. J., Verhaegh, K. J., van Meijel, B., & Francke, A. L. (2019). A systematic review of palliative care tools and interventions for people with severe mental illness. BMC Psychiatry, 19(1), 1-11.

Craster, L., & Forrester, A. (2020). The early identification of people with personality disorders in the criminal justice system. Medicine, Science and the Law, 60(4), 294-300.

Scott, K. M., De Vries, Y. A., Aguilar-Gaxiola, S., Al-Hamzawi, A., Alonso, J., Bromet, E. J., & De Jonge, P. (2020). Intermittent explosive disorder subtypes in the general population: association with comorbidity, impairment, and suicidality. Epidemiology and psychiatric sciences, 29.